Improving identification of HIV-associated neurocognitive disorder (HAND) in Latin America: A multimodal approach to HAND in Peru
June 19, 2026
January 1, 2023
Monica Diaz, MD, MS
Increase outreach of project/program
NIH National Institute of Mental Health (1-K23-MH131466-01)
University of North Carolina at Chapel Hill / Universidad Peruana Cayetano Heredia
HIV-associated neurocognitive disorder (HAND) is a pressing issue in low- and middle-income countries with increasing access to antiretroviral therapy, highlighting the urgent need to optimize diagnostics and prediction of HAND for early interventions. Dr. Diaz’s research plan outlined in this application leverages pilot data that demonstrated that nearly 30% of people living with HIV in Lima had HAND, yet diagnostics for HAND are limited in Latin America given a lack of regional normative data and experts in neuropsychological testing. The proposed research includes a prospective cohort of patients with HIV and HIV-negative controls from two socioeconomically-distinct HIV clinics in Lima. The study seeks to adapt and validate a tablet-based cognitive screening tool currently optimized for early Alzheimer’s screening to detect HAND in Peru. Known modifiable risk factors for cognitive impairment, including social determinants of health, will be used to build a predictive statistical model for HAND in Peru that can identify intervenable factors. These two tools will be implemented, evaluated and optimized through iterative rounds of interviewing with HIV care providers.